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Individual

MARY JULIE CROCCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
4422 3RD AVE, DEPARTMENT OF OBSTETRICS & GYNECOLOGY, BRONX, NY 10457-2545
(718) 960-9415
Mailing address
4422 3RD AVE, DEPARTMENT OF OBSTETRICS & GYNECOLOGY, BRONX, NY 10457-2545
(718) 960-9415

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
000124
CT
367A00000X
Advanced Practice Midwife
Primary
000158
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000124
CONNECTICARE
CT
01
00195491003
UHC
CA
05
004180452
CT
01
004180452-00
ANTHEM
CT
01
0508566
CIGNA
CT
01
OV6320
HEALTHNET
CT
01
P1904733
OXFORD
CT
Enumeration date
01/31/2006
Last updated
05/01/2012
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